Indistinct relapses

A lot of us on the MS forum seem to struggle with the concept of relapses and remissions. We've had a lot of discussions about this, but it can still be difficult to grasp.

I was wondering if you wouldn't mind saying something about Ess' question on the thread on "Slow or 'looking back' relapses" at http://www.medhelp.org/posts/show/716631. She asked if "various symptoms that develop over time, or take a long time to be characterized, constitute a relapse?"

Is it possible to have a relapse or remission and not know it?

Can a relapse come on slowly or does it come on with a clearly identifiable beginning?

Can remissions come on more slowly?

Can things keep slowly getting worse for a while (months) or is that not a relapse anymore?

Is there some rule of thumb for distinguishing "subtle" relapses from progression or do they just blend into each other?

I guess that's more than one question, but if you could just say something in general about this, I think your perspective would be helpful to me and some others.

Thank you.

sho

[Dr. Daniel Kantor, MD]

Great questions.

Please refer to:

http://www.*************.com/multiple-sclerosis/c/428/18973/relapse

Basically a relapse is a neurological symptom that last for weeks to months (although it is defined as greater than 24 hours, it is almost never that short) and then improves (not necessarily back to baseline).

Progression is when even in between relapses there is a slow decline.

[Sunnytoday]

Please note that your website link was not able to get through the censors here at medhelp. Can you please try again, and this time place a few extra spaces? I would love to read the article you refer to.... your response was helpful.
Thank you.
~Sunnytoday~

[Dr. Daniel Kantor, MD]

h e a l t h c e n t r a l